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Individual

LANE LESTER SMOTHERS

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
419 S WASHINGTON ST, SUITE 102, CASPER, WY 82601-2951
(307) 577-4220
(307) 235-0931
Mailing address
419 S WASHINGTON ST, SUITE 102, CASPER, WY 82601-2951
(307) 577-4220
(307) 235-0931

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
6580A
WY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0069853
MT
05
0575159
IA
01
308892
BLUE CROSS BLUE SHIELD
WY
05
8359358
WA
05
97383848
CO
Enumeration date
09/21/2005
Last updated
07/09/2007
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